ObjectiveTo investigate the application value of Toshiba 320-row dynamic volumetric CT angiography in the diagnosis of venous erectile dysfunction (VED).

METHODSWe enrolled in this study 33 patients diagnosed with ED by audiovisual sexual stimulation screening in the outpatient department. Penile erection was induced in the patients by injection of 2 mg phentolamine plus 30 mg papaverine into the corpus cavernosum, followed by that of contrast agent of iobitridol through the vein and corpus cavernosum successively. Then 320-row dynamic volumetric CT angiography was performed and the images of the corpus cavernosum in the arterial and venous phases were collected and processed.

RESULTSDifferent degrees of abnormal venous drainage were observed in 29 of the patients, including 7 cases (24.1%) of back deep venous leakage, 6 cases (20.7%) of foot venous leakage, 3 cases (10.3%) of dorsal superficial venous leakage, 1 case (3.5%) of intervertebral venous leakage, 2 cases (6.9%) of cavernous venous leakage, and 10 cases (34.5%) of mixed venous leakage. Ten of the patients underwent surgery, dorsal deep penile vein ligation in 2 cases, dorsal deep vein embedding plus foot vein ligation in 4, and foot vein ligation in the other 4. Eight of the patients were followed up for 3－12 months post-operatively, during which 2 achieved obvious erectile improvement, while the other 6 gained normal penile erection.

CONCLUSIONSToshiba 320-row dynamic volumetric CT angiography is a reliable method for the diagnosis of VED, which displays the precise location of venous leakage for clinical treatment, with the advantages of clearer images, lower doses of contrast agent and radiation, and faster examination than X-ray penile angiography.

Adult ; Arteries ; diagnostic imaging ; Computed Tomography Angiography ; Contrast Media ; Drug Combinations ; Erectile Dysfunction ; diagnostic imaging ; Humans ; Injections ; Iohexol ; analogs & derivatives ; Ligation ; Male ; Middle Aged ; Papaverine ; administration & dosage ; Penile Erection ; Penis ; diagnostic imaging ; physiopathology ; Phentolamine ; administration & dosage ; Veins ; diagnostic imaging ; surgery

OBJECTIVE: To investigate the validity of the 100 kVp setting in CT venography (CTV) in the diagnosis of deep vein thrombosis (DVT), and to evaluate the feasibility of reducing the amount of administered iodine in this setting. MATERIALS AND METHODS: After receiving the contrast medium (CM) of 2.0 mL/kg, 88 patients underwent CTV of the pelvis and lower extremities by using one of four protocols: Group A, 120 kVp setting and 370 mgI/mL CM; group B, 120 kVp and 300 mgI/mL; group C, 100 kVp and 370 mgI/mL; group D, 100 kVp and 300 mgI/mL. The groups were evaluated for venous attenuation, vein-to-muscle contrast-to-noise ratio (CNRVEIN), DVT-to-vein contrast-to-noise ratio (CNRDVT), and subjective degree of venous enhancement and image quality. RESULTS: Venous attenuation and CNRVEIN were significantly higher in group C (144.3 Hounsfield unit [HU] and 11.9), but there was no significant difference between group A (118.0 HU and 8.2) and D (122.4 HU and 7.9). The attenuation value of DVT was not significantly different among the four groups, and group C had a higher absolute CNRDVT than the other groups. The overall diagnostic image quality and venous enhancement were significantly higher in group C, but there was no difference between groups A and D. CONCLUSION: The 100 kVp setting in CTV substantially help improve venous enhancement and CNRVEIN. Furthermore, it enables to reduce the amount of administered iodine while maintaining venous attenuation, as compared with the 120 kVp setting.
Contrast Media/administration & dosage ; Feasibility Studies ; Female ; Humans ; Iohexol/administration & dosage/analogs & derivatives ; Linear Models ; Lower Extremity/blood supply/*radiography ; Male ; Middle Aged ; Phantoms, Imaging ; Phlebography/*methods ; Statistics, Nonparametric ; Tomography, X-Ray Computed/*methods ; Venous Thrombosis/*radiography

OBJECTIVE: To assess the technical feasibility and local efficacy of biplane fluoroscopy plus US-guided percutaneous radiofrequency ablation (RFA) for viable hepatocellular carcinoma (HCC) around retained iodized oil after transcatheter arterial chemoembolization (TACE). MATERIALS AND METHODS: Our prospective study was approved by our institutional review board and informed consent was obtained from all participating patients. For patients with viable HCC around retained iodized oil after TACE, biplane fluoroscopy plus US-guided RFA was performed. We evaluated the rate of technical success and major complications on a post-RFA CT examination and local tumor progression with a follow-up CT. RESULTS: Among 40 consecutive patients, 19 were excluded due to one of the following reasons: poorly visible HCC on fluoroscopy (n = 13), high risk location (n = 2), RFA performed under monoplane fluoroscopy and US guidance (n = 2), and poorly identifiable new HCCs on US (n = 2). The remaining 21 patients with 21 viable HCCs were included. The size of total tumors ranged from 1.4 to 5.0 cm (mean: 3.2 cm) in the longest diameter. Technical success was achieved for all 21 HCCs, and major complications were observed in none of the patients. During the follow-up period (mean, 20.3 months; range, 6.5-29.9 months), local tumor progression was found in two patients (2/21, 9.5%). Distant intrahepatic metastasis developed in 76.2% (16/21) of patients. CONCLUSION: When retained iodized oil around the tumor after TACE hampers the targeting of the viable tumor for RFA, biplane fluoroscopy plus US-guided RFA may be performed owing to its technical feasibility and effective treatment for viable HCCs.
Aged ; Aged, 80 and over ; Carcinoma, Hepatocellular/radiography/*surgery/therapy ; *Catheter Ablation ; *Chemoembolization, Therapeutic ; Complex Mixtures ; *Contrast Media ; Female ; *Fluoroscopy/methods ; Humans ; Iodized Oil/*administration & dosage ; Iohexol/analogs & derivatives/diagnostic use ; Liver Neoplasms/radiography/*surgery/therapy ; Male ; Middle Aged ; *Ultrasonography, Interventional

BACKGROUNDDamage to the spinal cord after the treatment of the descending thoracic and thoracoabdominal aortic aneurysms is an uncommon but devastating complication. The artery of Adamkiewicz (AKA) is the principal arterial supply of the anterior spinal artery (ASA) in the lower thoracic and lumbar level. The purpose of this study was to evaluate the visualization of the anterior spinal artery and the artery of Adamkiewicz, the affecting factors for the detection rate using multi-detector row CT (MDCT).

METHODSNinety-nine consecutive patients (31 women and 68 men; age range, 25 - 90 years; average age 61.3 years), with suspicion for thoracic aortic lesions necessitating surgical intervention (31 aortic aneurysm, 45 dissection, 5 intramural hematoma, and 18 normal), underwent CT angiography from the aortic arch to the aortic bifurcation. Transverse sections, multiplanar reformations and thin maximum intensity projections were used to assess the ASA and AKA. The level of the ASA and AKA origins and CT acquisition parameters were recorded. The contrast-to-noise ratio of the image, an index of the mass of the T11 body (vertebral mass index), the subcutaneous fat thickness, and the CT value within the aortic arch and at the T11 level were measured. The detection of the ASA and AKA were evaluated relative to the acquisition parameters, scan characteristics, and aortic lesion type. Differences were assessed with the Wilcoxon rank-sum and t tests.

RESULTSThe ASA was visualized in 51 patients (52%) and the AKA in 18 patients (18%). The ASA was identified in 36/67 patients (54%) with 1.25 mm thickness and in 15/32 patients (47%) with 2.5 - 3.0 mm thickness. This difference did not achieve significance (P = 0.13). The detection rate of the ASA and the AKA was influenced by the vertebral mass index and the contrast-to-noise ratio (P < 0.05). The amount of subcutaneous fat affected the detection rate of the ASA (P < 0.05) but not the AKA. In CT scans of ASA detection, the mean CT values in the aorta at the arch and at T11 were 360 and 358 HU, respectively, whereas in CT scans without ASA detection, the CT values in the aorta at the arch and at T11 were lower (P < 0.05), 297 and 317 HU, respectively.

CONCLUSIONSThe ASA and AKA were less frequently detected in our cohort than previous reports. The visualization of the ASA and AKA was significantly affected by aortic enhancement, the "vertebral mass index", and the contrast-to-noise ratio.

Adult ; Aged ; Aged, 80 and over ; Angiography ; methods ; Aortic Aneurysm, Thoracic ; diagnostic imaging ; pathology ; surgery ; Contrast Media ; administration & dosage ; Female ; Humans ; Iohexol ; administration & dosage ; Male ; Middle Aged ; Spinal Cord ; blood supply ; diagnostic imaging ; pathology ; Tomography, X-Ray Computed ; methods

OBJECTIVE: This study was designed to investigate the effect of administration of warmed contrast material (CM) on the bolus geometry and enhancement as depicted on coronary CT angiography. MATERIALS AND METHODS: A total of 64 patients (42 men, 22 women; mean age, 56 years) were randomly divided into two groups. Group 1 included 32 patients administered CM (Omnipaque [Iohexol] 350 mg I/ mL; Nycomed, Princeton, NJ) saline solutions kept in an incubator at a constant temperature (37degrees C). Group 2 included 32 patients administered the CM saline solutions kept at constant room temperature (24degrees C). Cardiac CT scans were performed with a dual source computed tomography (DSCT) scanner. For each group, region of interest curves were plotted inside the ascending aorta, main pulmonary artery and descending aorta on test bolus images. Using enhancement values, time/enhancement diagrams were produced for each vessel. On diagrams, basal Hounsfield unit (HU) values were subtracted from sequentially obtained values. A value of 100 HU was accepted as a cut-off value for the beginning of opacification. The time to peak, the time required to reach 100 HU opacification, maximum enhancement and duration of enhancement above 100 HU were noted. DSCT angiography studies were evaluated for coronary vessel enhancement. RESULTS: Maximum enhancement values in the ascending aorta, descending aorta and main pulmonary artery were significantly higher in group 1 subjects. In the ascending aorta, the median time required to reach 100 HU opacification during the test bolus analysis was significantly shorter for group 2 subjects than for group 1 subjects. In the ascending aorta, the descending aorta and main pulmonary artery, for group 1 subjects, the bolus geometry curve shifted to the left and upwards as compared with the bolus geometry curve for group 2 subjects. CONCLUSION: The use of warmed CM yields higher enhancement values and a shorter time to reach maximum enhancement duration, resulting in a shift of the bolus geometry curve to the left that may provide optimized image quality.
Adult ; Aged ; Contrast Media/*administration & dosage ; *Coronary Angiography ; Female ; Humans ; Image Enhancement ; Image Processing, Computer-Assisted ; Injections, Intravenous ; Iohexol/*administration & dosage ; Male ; Middle Aged ; Prospective Studies ; *Temperature ; Tomography, X-Ray Computed

Fenestrated endovascular repair of an abdominal aortic aneurysm has been developed to treat patients with a short or complicated aneurysm neck. Fenestration involves creating an opening in the graft fabric to accommodate the orifice of the vessel that is targeted for preservation. Fixation of the fenestration to the renal arteries and the other visceral arteries can be done by implanting bare or covered stents across the graft-artery ostia interfaces so that a portion of the stent protrudes into the aortic lumen. Accurate alignment of the targeted vessels in a longitudinal aspect is hard to achieve during stent deployment because rotation of the stent graft may take place during delivery from the sheath. Understanding the 3D relationship of the aortic branches and the fenestrated vessel stents following fenestration will aid endovascular specialists to evaluate how the stent graft is situated within the aorta after placement of fenestrations. The aim of this article is to provide the 2D and 3D imaging appearances of the fenestrated endovascular grafts that were implanted in a group of patients with abdominal aortic aneurysms, based on the multislice CT angiography. The potential applications of each visualization technique were explored and compared with the 2D axial images.
Aged ; Aged, 80 and over ; Aorta, Abdominal/radiography ; Aortic Aneurysm, Abdominal/*radiography/*surgery ; *Blood Vessel Prosthesis ; Contrast Media/administration & dosage ; Female ; Humans ; Image Processing, Computer-Assisted/methods ; Imaging, Three-Dimensional/*methods ; Iohexol/administration & dosage/analogs & derivatives ; Male ; Middle Aged ; Prosthesis Design ; Radiographic Image Enhancement/methods ; *Stents ; Tomography, X-Ray Computed/*methods

OBJECTIVE: This study was conducted to assess the feasibility of performing 100-kVp electrocardiogram (ECG)-gated coronary CT angiography, as compared to 120-kVp ECG-gated coronary CT angiography. MATERIALS AND METHODS: We retrospectively evaluated one hundred eighty five gender- and body mass index-matched 16-slice coronary CT sets of data, which were obtained using either 100 kVp and 620 effective mAs or 120 kVp and 500 effective mAs. The density measurements (image noise, vessel density, signal-to-noise ratio [SNR] and contrast-to-noise ratio [CNR]) and the estimated radiation dose were calculated. As a preference test, two image readers were independently asked to choose one image from each pair of images. The results of both protocols were compared using the paired t-test or the Wilcoxon signed rank test. RESULTS: The 100-kVp images showed significantly more noise and a significantly higher vessel density than did the 120-kVp images. There were no significant differences in the SNR and CNR. The estimated reduction of the radiation dose for the 100-kVp protocol was 24%; 7.8 +/- 0.4 mSV for 100-kVp and 10.1 +/- 1.0 mSV for 120-kVp (p < 0.001). The readers preferred the 100-kVp images for reading (reader 1, p = 0.01; reader 2, p = 0.06), with their preferences being stronger when the subject's body mass index was less than 25. CONCLUSION: Reducing the tube kilovoltage from 120 to 100 kVp allows a significant reduction of the radiation dose without a significant change in the SNR and the CNR.
Adult ; Aged ; Aged, 80 and over ; Contrast Media/administration & dosage ; Coronary Angiography/*methods ; Electrocardiography/*methods ; Feasibility Studies ; Female ; Humans ; Iohexol/administration & dosage/analogs & derivatives ; Male ; Middle Aged ; Observer Variation ; *Radiation Dosage ; Radiographic Image Enhancement/methods ; Retrospective Studies ; Tomography, X-Ray Computed/*methods

OBJECTIVE: This study was designed to determine the optimal mixture ratio of gadolinium and iodinated contrast agent for simultaneous direct MR arthrography and CT arthrography. MATERIALS AND METHODS: An in vitro study was performed utilizing mixtures of gadolinium at six different concentrations (0.625, 1.25, 2.5, 5.0, 10 and 20 mmol/L) and iodinated contrast agent at seven different concentrations (0, 12.5, 25, 37.5, 50, 75 and 92-99.9%). These mixtures were placed in tissue culture plates, and were then imaged with CT and MR (with T1-weighted sequences, proton-density sequences and T2-weighted sequences). CT numbers and signal intensities were measured. Pearson's correlation coefficients were used to assess the correlations between the gadolinium/iodinated contrast agent mixtures and the CT numbers/MR signal intensities. Scatter diagrams were plotted for all gadolinium/iodinated contrast agent combinations and two radiologists in consensus identified the mixtures that yielded the optimal CT numbers and MR signal intensities. RESULTS: The CT numbers showed significant correlation with iodinated contrast concentrations (r = 0.976, p < 0.001), whereas the signal intensities as measured on MR images showed a significant correlation with both gadolinium and iodinated contrast agent concentrations (r = -484 to -0.719, p < 0.001). A review of the CT and MR images, graphs, and scatter diagram of 42 combinations of the contrast agent showed that a concentration of 1.25 mmol/L gadolinium and 25% iodinated contrast agent was the best combination for simultaneous CT and MR imaging. CONCLUSION: A mixture of 1.25 mmol/L gadolinium and 25% iodinated contrast agent was found to be optimal for simultaneous direct MR arthrography and CT arthrography.
*Arthrography ; Contrast Media/*administration & dosage ; Gadolinium/administration & dosage/*diagnostic use ; Iohexol/administration & dosage/*analogs & derivatives/diagnostic use ; *Magnetic Resonance Imaging ; Meglumine/administration & dosage/*diagnostic use ; Organometallic Compounds/administration & dosage/*diagnostic use ; Phantoms, Imaging ; *Tomography, X-Ray Computed

The liposomes were prepared by reverse-phase evaporation technique. The morphology of the liposomes, the entrapment efficiency and the particle size distribution were evaluated. The CT signals of Iohexol liposomes in rabbits were compared with those of Iohexol injection in rabbits. The entrapment efficiency of Iohexol liposomes was 82.35% +/- 1.82%. The liposmes were spherical or ellipsoidal shape in shape. The mean diameter of the Iohexol liposomes was 207 7 nm. The polydispersity index was 0.355. The Zeta potential was--1.83 mV. The drug was highly entrapped into the liposomes with good reproduction and stability. The in vitro release of Iohexol liposomes was significantly slower than that of Iohexol,and was 98.57% at 24 h. Iohexol liposomes may reduce the dosage, prolong the effective time of the developing agent, and could reduce the side effects of Iohexol on the blood vessels and cerebral nerves.
Animals ; Contrast Media ; chemical synthesis ; chemistry ; Drug Carriers ; Drug Delivery Systems ; Iohexol ; chemical synthesis ; chemistry ; Liposomes ; administration & dosage ; chemical synthesis ; Microscopy, Electron, Scanning ; Particle Size ; Rabbits ; Random Allocation

OBJECTIVE: To investigate the serial CT findings of Paragonimus westermani infected dogs and the microscopic structures of the worm cysts using Micro-CT. MATERIALS AND METHODS: This study was approved by the committee on animal research at our institution. Fifteen dogs infected with P. westermani underwent serial contrast-enhanced CT scans at pre-infection, after 10 days of infection, and monthly thereafter until six months for determining the radiologic-pathologic correlation. Three dogs (one dog each time) were sacrificed at 1, 3 and 6 months, respectively. After fixation of the lungs, both multi-detector CT and Micro-CT were performed for examining the worm cysts. RESULTS: The initial findings were pleural effusion and/or subpleural ground-glass opacities or linear opacities at day 10. At day 30, subpleural and peribronchial nodules appeared with hydropneumothorax and abdominal or chest wall air bubbles. Cavitary change and bronchial dilatation began to be seen on CT scan at day 30 and this was mostly seen together with mediastinal lymphadenopathy at day 60. Thereafter, subpleural ground-glass opacities and nodules with or without cavitary changes were persistently observed until day 180. After cavitary change of the nodules, the migratory features of the subpleural or peribronchial nodules were seen on all the serial CT scans. Micro-CT showed that the cyst wall contained dilated interconnected tubular structures, which had communications with the cavity and the adjacent distal bronchus. CONCLUSION: The CT findings of paragonimiasis depend on the migratory stage of the worms. The worm cyst can have numerous interconnected tubular channels within its own wall and these channels have connections with the cavity and the adjacent distal bronchus.
Animals ; Contrast Media/administration & dosage ; Cysts/*parasitology/*radiography ; Disease Progression ; Dogs ; Female ; Follow-Up Studies ; Hydropneumothorax/parasitology ; Iohexol/analogs & derivatives/diagnostic use ; Lung/parasitology/radiography ; Male ; Observer Variation ; Paragonimiasis/*diagnosis/parasitology ; Paragonimus westermani/growth & development/isolation & purification ; Pleural Effusion/parasitology ; Radiographic Image Enhancement/methods ; Time Factors ; Tomography, X-Ray Computed/*methods